Biomedical subjects

D Groenemeyer

Publications and source records attributed to D Groenemeyer.

3 recordsLinked to original sources

PubMed2002

CT-guided percutaneous radiofrequency denervation of the sacroiliac joint.

Defining the origin of low back pain is a challenging task. Among a variety of factors the sacroiliac joint (SIJ) is a possible pain generator, although precise diagnosis is difficult. Joint blocks may reduce pain, but are, in cases, of only temporary effect. This study was conducted to evaluate CT-guided percutaneous radiofrequency denervation of the sacroiliac joint in patients with low back pain. The procedure was performed on 38 patients who only temporarily responded to CT-guided SIJ blocks. The denervation was carried out in the posterior interosseous sacroiliac ligaments and on the dorsal rami of the fifth spinal nerve. All interventions were carried out under CT guidance as out-patient therapies. Three months after the therapy, 13 patients (34.2%) were completely free of pain. Twelve patients (31.6%) reported on a substantial pain reduction, 7 patients (18.4%) had obtained a slight and 3 patients (7.9%) no pain reduction. The data of 3 patients (7.9%) was missing. There were no intra- or postoperative complications. Computed tomography-guided percutaneous radiofrequency denervation of the sacroiliac joint appears safe and effective. The procedure may be a useful therapeutic modality, especially in patients with chronic low back pain, who only temporarily respond to therapeutic blocks.

Adult↗

PubMed1997

Comparison of electron beam computed tomography with intracoronary ultrasound and coronary angiography for detection of coronary atherosclerosis.

OBJECTIVES: This analysis compared the results of electron beam computed tomography (EBCT) with those of coronary angiography and intracoronary ultrasound (ICUS) for the in vivo detection of coronary atherosclerotic plaques. BACKGROUND: EBCT is a new imaging modality for identification of coronary calcifications. Coronary angiography depicts advanced changes in coronary morphology, whereas ICUS is an established diagnostic tool that detects the early stages of coronary artery disease. METHODS: In 57 patients (54 +/- 9 years old), 267 coronary segments were analyzed with EBCT (3-mm slices, acquisition time 100 ms, threshold definition of coronary calcification at 130 Hounsfield units in an area > or = 1 mm2, Agatston calcium score), coronary angiography and ICUS. The analysis was based on the number and extent of coronary calcifications on EBCT, coronary lumen reduction on coronary angiography and plaque formation with and without ultrasound signs of calcifications on ICUS. RESULTS: Compared with coronary angiography, EBCT yielded a sensitivity of 66%, a specificity of 78%, a positive predictive value of 39% and a negative predictive value of 91%. Compared with ICUS, EBCT yielded an overall sensitivity of 66%, a specificity of 88% and an overall accuracy of 81%. For plaques with and without ultrasound signs of calcifications, the sensitivity of EBCT was 97% and 47%, specificity 80% and 75% and overall accuracy 82% and 69%, respectively. CONCLUSIONS: This in vivo correlation between ICUS and EBCT demonstrates that EBCT is a noninvasive method that helps to visualize the atherosclerotic process by localization and quantification of coronary artery calcifications. EBCT detects calcified plaques with high accuracy. Plaques without ultrasound signs of calcifications can be detected by EBCT but with lower sensitivity but equivalent specificity.

Adult↗

PubMed1995

Ports, Trocars/Cannulae, and Access Techniques.

One of the keys to safe laparo-endoscopic surgery is an expeditious, reliable, and safe access to the operative field. Aside from appropriate surgical technique, the technology of trocars, cannulae, and other endoscopically guided insertion techniques plays a decisive role for safe identification of and access to the peritoneal cavity. This report takes a close look at critical features of trocar and cannula design for blind insertion with the focus on the biomechanical principles involved in traversing the abdominal wall. Particular attention has been paid to techniques minimizing the risk of accidental injury to major vessels, intestine, and other important structures. The principle of controlled visualized access led to several developments in the field of trocars, cannulae, and puncture techniques. Aside from blind and open access with the Veress needle, conventional trocars and cannulae, a selected variety of endoscopically assisted ports such as the optical Veress needle, optical trocars and optical scalpel, and a vacuum-supported access system are described in detail.

Journal Article↗